Standard Head Neck Exam

Question 0

Test for facial muscle function by asking the patient to

Answer 0

wrinkle forehead, squeeze eyes shut, smile, puff out cheeks

Question 1

Verbalize while inspecting facial features, hair, scalp and skull

Answer 1

“the head is normocephalic and atraumatic, face is symmetrical without lesions.”

Question 2

Which nerve is responsible for facial motor fuction?

Answer 2

CN VII (Facial)

Question 3

How to test for CN V sensory? How to verbalize?

Answer 3

Light touch to FH, cheeks, chin

“Close your eyes. Say “now each time you feel me touch your face”

Question 4

While palpating facial bones and sinus, say

Answer 4

“Now I will palpate facial bones and frontal and maxillary sinuses”

Question 5

What nerve is tested by palpating masseter m?

Answer 5

CN V motor

Question 6

While palpating TMJ and ROM and masseter, say

Answer 6

“Open your mouth, move your jaw from side to side and clench your teeth. CN V motor is intact.”

Question 7

When palpating hair, scalp and skull say

Answer 7

“Symmetrical hair distribution, hair is coarse (straight, curly)”

Question 8

While inspecting hearing, say

Answer 8

(rub fingers next to each ear) “Tell me when you hear my fingers rubbing rogether”

Question 9

To inspect auricle and surrounding tissue, say

Answer 9

“I am going to INSPECT ears and PALPATE for any signs of lumps, masse, lesions, battle signs, tragial or mastoid tenderness. There is no discoloration of the mastoid, no edema, no ecchymosis (bruises)”

Question 10

ecchymosis

Answer 10

bruise ?

Question 11

battle sign is

Answer 11

basilar skull fracture

Question 12

While performing otoscopic exam, say

Answer 12

“canals are clear. TM is pearly gray and translucent, light reflex present, landmarks are normal. No fluid in the middle ear”

Question 13

When inspecting and palpating nose, say

Answer 13

“I am going to palpate the nasal bone - everything is normal. Nose is midline without lesions.”

Question 14

To test for nasal patency, say

Answer 14

“Occlude one nostril with your index finger and sniff/breath in”

Question 15

During speculum exam say

Answer 15

“Mucosa is pink and moist without lesions, no septal deviations, turbinates are normal, no lesions or polyps”

Question 16

While inspecting lips say

Answer 16

Lips are red, without lesions

Question 17

While inspecting teeth, gums, mouth odor say

Answer 17

” Teeth are in good shape, non tender, good oral hygiene, breath odor is non offensive”

Question 18

While inspecting inside the mouth, say

Answer 18

“I am inspecting the buccal (buckle) mucose, Stenson’s duct (parotid duct), posterior pharynx, pillar and tonsils for size and color.”

Question 19

Ask pt to lift their tongue

Answer 19

“Floor of mouth and Wharton’s duct are normal”

Question 20

By asking pt to say “Ah”, which nerve is tested?

Answer 20

CN IX and X

Question 21

Ask pt to say “Ah”

Answer 21

“Palate and uvula elevate/raise symmetrically. CN 9 and 10 are intact. No sign of distressed teeth or tenderness.”

Question 22

By asking a pt to protrude the tongue and move it side to side, which nerve is tested?

Answer 22

CN XII

Question 23

When asking a pt to stick tongue out and move side to side, say

Answer 23

“Tongue is midline without deviation. CN 12 is intact.”

Question 24

When palpating oral cavity with glove (BIMANUAL)

Answer 24

“I am feeling buccal tissue, the sulcus, the gingiva, floor of mouth and other side. Everything feels healthy and normal.”

Question 25

When inspecting anterior neck, you are inspecting for (6)

Answer 25

symmetry, fullness, masses, thyromegaly, jugular venous distension, tracheal alighnment

Question 26

To test neck ROM:

Answer 26

“touch your chin to your chest, look up at the ceiling” : flexion-extention
“Loor to the R, then L” - lateral rotation
“tilt your ear twrd your shoulder, now the other side” - lateral flexion

Question 27

To test lateral rotation against resistance, say:

And which nerve is tested?

Answer 27

“Checking ROM against resistance: try to turn your head against my hand. CN 11 is intact”

Question 28

to test CN XI, ask pt to

Answer 28

• shrug your shoulders against my resistance/hands

- try to turn your head against my hand (lateral rotation)

Question 29

While palpating lymph nodes, say

Answer 29

"I am palpating:
occipital,
pre-auricular,
post-auricular,
tonsilar,
submandibular
submental
anterior cervical (superficial and deep)
posterior cervical (sup and deep)
supraclavicular nodes

Question 30

While palpating carotid arteries and tracheal position, say

Answer 30

“Next I am going to palpate carotid arteries (while pt holds breath?) and auscultate for any bruits. Carotids are 2+ bilaterally”

“Next I will check tracheal position and mobility. Trachea is midline” (examine from front of pt)

Question 31

How do you palpate thyroid

How to verbalize

Answer 31

From behind and ask patient to swallow

“Next I am going to feel your thyroid and ask you to swallow. Thyroid is normal in size and consistency w/o nodules”

Question 32

Which nerve is responsible for taste?

Answer 32

CN VII (facial)

Question 33

Which nerve is responsible for gag reflex/ uvula vs tongue movement?

Answer 33

CN IX and X (Glossopharyngeal and Vagus): gag/uvula (say "Ah")
CN XII (hypoglossal) : tongue protruding and side to side